Case Manager Assistant – LPN

November 20

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MedWatch, LLC

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Healthcare Insurance • B2B

MedWatch, LLC is a healthcare services company that provides utilization management, case management, disease management, member advocacy and concierge care coordination to payers, TPAs, and self‑insured employers. For over 35 years it has delivered clinically driven care management, precertification and claims solutions, direct contracting and ancillary services backed by URAC accreditations and proprietary in‑house technology to improve clinical outcomes and reduce plan and member costs.

201 - 500 employees

Founded 1988

⚕️ Healthcare Insurance

🤝 B2B

📋 Description

• assists the RN Case Manager in performing necessary functions using the case management process • authorization of services • review of treatment plans for medical necessity • ongoing communication with all members of the health care team • operate under the direct supervision of the RN Case Manager • review all medical data to update a case management plan • make contact with the payer office to understand any benefit constraints • contact medical care providers and equipment vendors to verify medical necessity • make care arrangements for quality patient care • negotiate with providers to maximize medical benefits available to the patient • maintain case in computer system documenting case actions for each patient • prepare timely reports to the payer to detail all case actions

🎯 Requirements

• Licensed Practical Nurse or Medical Assistant/Nursing Assistant Certification (current active and unrestricted, in current state of practice and residence, within the United States or its territories) • Licensed Practical Nursing Education preferred • Basic Computer skills

🏖️ Benefits

• paid time off • medical • dental • vision • short and long-term disability • life insurance • AD&D • 401k with match • critical illness coverage • legal plan • identity theft coverage • pet insurance • discount programs